透明敷料不同更换频率对新生儿中心静脉导管相关性感染的影响

Effect of transparent dressings replacing in different frequency on neonatal central venous catheter-related infections

  • 摘要: 目的 探讨新生儿经外周静脉置入中心静脉导管(PICC)后,透明敷料不同更换频率对导管感染发生的影响,为透明敷料选取合适的更换频率提供理论依据。方法 选取2012年6月-2015年6月在医院接受留置PICC导管的450例新生儿为研究对象,按照随机的方式将其平均分成3组,其中Ⅰ组每3 d更换一次敷料,Ⅱ组每5 d更换一次敷料,Ⅲ组每7 d更换一次敷料,分析比较3组新生儿导管相关感染的发生。结果 450例新生儿中共有21例发生导管口感染,感染率为4.67%;3组新生儿病原菌检出均以表皮葡萄球菌最多,分别占57.14%、71.42%、49.99%,其次为肺炎克雷伯菌,分别占42.86%、14.29%、16.67%;发生导管相关的血液感染,Ⅰ、Ⅱ组感染率均为0.67%,Ⅲ组未发生导管相关的血流感染。<目的 建议新生儿中心静脉导管的敷料更换频率为每7天1次,减少医护人员的工作量,降低医院感染率,敷料出现潮湿、松动等现象时,应及时更换。

     

    Abstract: OBJECTIVE To investigate neonatal peripherally inserted central catheter (PICC), and effect of transparent dressings replacing in different frequency on neonatal central venous catheter-related infections, in order to select the appropriate transparent dressing change frequency to provide a theoretical basis. METHODS A total of 450 neonates indwelling PICC catheter in hospital from Jun. 2012 to Jun. 2015 were selected as research subjects, in a random manner patients were divided into three groups, in which group Ⅰ dressing changed once every three days, group Ⅱonce every five days, group Ⅲ once every 7 days, the catheter-related infection were analyzed and compared in three groups of children. RESULTS A total of 21 cases of patients got infections from 450 patients, and the infection rate was 4.67%; Staphylococcus epidermidis were the top bacteria detected out from the three groups of children, accounting for 57.14%, 71.42% and 49.99% respectively, followed by Klebsiella pneumoniae, accounting for 42.86%, 14.29% and 16.67% respectively.The incident rates of catheter-related infection in groupⅠand Ⅱ both 0.67%, and group Ⅲ had no catheter-related bloodstream infections. CONCLUSION We recommend that the dressing central venous catheters in neonates replacement frequency is 7 days / time to reduce the workload of medical staff, reduce the incidence of nosocomial infections, but if dressings appear moist and loose phenomenon happen, the cathether should be replaced.

     

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